Organization
CRAWFORD SURGICARE
Active
Parent organization
W JACOBSEN DPM PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
W JACOBSEN DPM PC
Authorized official
DR. WALTER JACOBSEN DPM (PRESIDENT)
(773) 582-7100
Entity
Organization
Contact information
Practice address
6441 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 582-7100
(773) 561-1111
Mailing address
6441 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 582-7100
(773) 561-1111
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
016004485
IL
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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